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“More than meets the Eye”

Christie Russo

 

   

 

"EMDR (Eye Movement Desensitization and Reprocessing) therapy has emerged as a
procedure to be reckoned with in psychology....Almost a million people have been treated ....
Also, further research appears to support the remarkable claims made for EMDR therapy."
- Reported in The Washington Post, July 21, 1995

"Where traditional therapies may take years, EMDR takes only a few sessions."
- Reported in The Stars and Stripes, February 12, 1995

"New type of psychotherapy seen as boon to traumatic disorders."
- Reported in The New York Times, October 26, 1997

 

EYE

 

 

What is Eye Movement Desensitization and Reprocessing?

 

EMDR combines brief periods of exposure with an external distracting stimulus…

 

EMDR is a relatively new and contentious clinical treatment that has been scientifically evaluated predominantly with trauma survivors and persons stricken with anxiety.  The premise of EMDR is that traumatic, panic, and anxiety experiences are processed differently by the brain than pleasant or neutral experiences.  EMDR maintains that the amygdala (part of the temporal lobe responsible for moderating emotions) provisionally shuts down the hippocampus (complex region in the temporal lobe responsible for long-term memories) resulting in a heightened reaction to the specific event.  Theoretically the memory of the disturbing experience is trapped beyond the domain of usual brain-processing abilities.  EMDR grants the patient admission to the experience so that he/she can convert it into a tolerable or neutral memory.  The neuro-physiological concept behind EMDR is that the hippocampus is not entirely shut down by the emotions evoked from the induced experience.  Therefore, the patient is able to endure the procedure.  Distraction by bilateral stimulation catalyzes rapid eye movements (REM) similar to that produced during sleep.   In theory the REM induced in an EMDR session trigger an accelerated processing system in which the patient is able to rapidly absolve upsetting experiences creating an adaptive learning experience.  In simpler terms, the patient learns to draw out what is necessary and useful from the upsetting incident.              

 


Who discovered the EMDR method and how?

             

 

 

 

 

 

 

                                      Francine Shapiro Ph.D.

 

Spring, 1987—Dr. Francine Shapiro made a chance observation.  She was walking one day and realized she was having particularly disturbing thoughts.  When they suddenly disappeared, her inquisitive nature wanted to know why?  So she attempted to re-evoke her previous thoughts back to mind.  However, she noticed that in doing so, they were “not as upsetting or as valid as before.”  Prior experience had taught her, “Disturbing thoughts…tend to play over and over until you consciously do something to stop or change them.”  So she began to pay very close attention to her environment and behavior.  Shapiro soon noticed that when the distressing thoughts entered her mind, her eyes began to move quickly, back and forth, in an upward diagonal.  Yet again, the negative thoughts disappeared.  When they were once again retrieved, their intensity appeared even more diminished.  Fascinated by this happenstance discovery, Shapiro began to test out her newfound strategy on friends and colleagues.  She discovered similar results and began to modify her strategy to achieve optimal outcomes.  Thus, EMDR entered the scientific realm and was ready to be tested for reliability and effectiveness. http://www.pseudoscience.org/rosen-and-lohr.htm

 

What, according to its founder, is the purpose of EMDR?

 

· to help the patient learn from negative past experiences

 

· to desensitize current triggers that are inappropriately distressing

 

· to incorporate templates for appropriate future actions that permit the patient to excel individually and within his/her interpersonal system

 

How does bilateral stimulation/distraction facilitate the processing of distressing experiences? 

 

Traditionally, during EMDR sessions, the patient envisions a traumatic or disturbing event whilst moving their eyes rapidly back and forth in an upward diagonal, following the movement of an instrument (pencil, finger, light) controlled by the therapist.  Studies have shown with an overwhelming rate of success that this process alleviates distress, however, the exact rationale is unknown. http://www.internalchange.com/tools/emdr.html

 

The first controlled study

The initial pilot research was executed by Francine Shapiro in the winter of 1987.  The 22 subjects of her study were victims of rape, molestation, or Vietnam veterans suffering from tormenting memories.  The subjects were randomly assigned to one of two groups: treatment or control.  The subjects receiving the treatment were administered EMDR whereas the control group received a placebo treatment consisting of a detailed dialogue in which the subject was asked to describe their traumatic recollection.   Subjects within both groups were requested to discuss their individual disturbing image along with whatever negative thoughts/beliefs they correlated with their participation in such an event (i.e. “I’m dirty,” “I’m worthless…not in control.”).  This negative connotation would be referred to as “the negative cognition.”  The subjects were then asked to rate their anxiety level according to an 11-point Subjective Units of Disturbance Scale (SUDS).  Zero would reflect a neutral or non-existent anxiety and ten would reflect the highest possible level of anxiety.  The subjects were also asked to voice a positive thought they would like to have about themselves.  Lastly, the subjects were asked to determine the validity of their positive thought, designated by the Validity of Cognition Scale (VOCS). 

The treatment group demonstrated a decreased level of anxiety and a substantial increase in the validity of positive cognition.  The control group, on the other hand, did not demonstrate such cognitive restructuring.  These subjects experienced an increase in anxiety as well as a decreased self-efficacy.    Shapiro’s study was the first of many to come to suggest EMDR has significant external validity.

 

 

 

 

Peer controlled Studies of EMDR

· “Marcus, Marquis, and Sakai (1997) evaluated sixty-seven individuals diagnosed with post-traumatic stress disorder (PTSD) in a controlled study funded by Kaiser Permanente Hospital.”  The results of this study indicate that EMDR may be a superior form of treatment for PTSD than those commonly practiced.  After merely three fifty-minute sessions, 50% of EMDR participants no longer qualified as diagnoses of PTSD compared to 20% of recipients of standard hospital care. 

 

· Soloman & Kaufman (1994) determined that when 60 railroad personnel suffering from traumatic incidents were debriefed by a peer counselor in conjunction with 20 minutes of EMDR (as opposed to no EMDR), they produced significantly better scores on the Impact of Event Scales.

http://www.emdr.com/studies.htm

 

· “Of 445 respondents to a survey of trained clinicians who had treated over 10,000 clients, 76% reported greater positive effects with EMDR than with other methods they had used.  Only 4% found fewer positive effects with EMDR.”  http://www.ejch.com/emdr.htm

 

Efficacy of EMDR

EMDR has been acknowledged as an “empirically validated treatment of trauma” and recognized by the International Society for Traumatic Stress Studies as “an effective treatment for PTSD.”  In 1998, the American Psychological Association Division 12 Task Force placed EMDR on a list of “probable efficacious treatments.” (Chambless, 1998)  This is most likely due to the extensive and highly reliable studies involving EMDR treatment in comparison to standardized treatments.

 

Since its original efficacy study (Shapiro, 1989) positive therapeutic results have been reported in a diverse group of populations:  http://www.emdr.com/eff.htm

Ž Combat veterans who were previously resistant to treatment no longer show symptoms (Blore, 1997)

Ž Persons with phobias and panic disorders no longer display the behaviour (de Jongh & ten Broeke, 1998)

Ž Disturbance of violent assault victims significantly reduced (McNally & Soloman, 1999)

Ž Victims of sexual dysfunction gain ability to maintain a healthy, sexual relationship (Wernik, 1993)

Ž Children traumatized by natural disaster or assault no longer possess symptoms of the trauma

Ž People affected by dissociative disorders progress at a faster rate than those receiving standard treatment (Young, 1994)

 

Who administers EMDR?

 

Administration of EMDR is limited to mental health professionals who have a masters degree or higher in the mental health field and are licensed or certified through a state or national board which authorizes independent practice.  http://www.emdr.com

 

Are there any side effects to EMDR?

 

Although negative side effects are not common, they are entirely possible.  This includes re-experiencing the negative event for several hours or days after treatment and temporarily increased anxiety.  There have been no long-term negative side effects reported in any data or research.

 

-----------------References-----------------

Corsini, R. (2001) Handbook of innovative psychotherapies  133

Phillips, M. (2000) Finding the energy to heal:hoe EMDR, Hypnosis, TFT, Imagery, and Body-Focused Therapy Can Help Restore Mindbody Health 240-248

Shapiro, F. (2001) Eye movement desensitization and reprocessing : basic principles, protocols, and procedures 1-6, 315-360

 

 

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